{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:58:18Z","timestamp":1791219498144,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:p>\n                    <jats:bold>\n                      <jats:italic>Background and Purpose\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    Excessive daytime sleepiness, one of the most frequent sleep complaints in the elderly, may affect survival, but inconsistent results have been observed in that population so far. We therefore estimated the risk of mortality for excessive daytime sleepiness (EDS) in community-dwelling elderly participating in the Three City Study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Methods\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    The Three City Study is a French population-based multicenter prospective study including 9294 subjects (60% women) aged \u226565 years at recruitment between 1999 to 2001. At baseline, 8269 subjects rated EDS and nocturnal sleep complaints as never, rare, regular, and frequent in response to an administered questionnaire and provided information on medication use for sleep or anxiety. Hazard ratios (HR) of EDS (regular or frequent) for mortality over 6 years were estimated by a Cox proportional hazard model.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Results\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    At baseline, 18.7% of the study participants had regular or frequent EDS. After 6 years of follow-up, 762 subjects had died including 260 from cancer and 196 from cardiovascular disease. EDS was associated with a significant 33% increased risk of mortality (95% CI: 1.13 to 1.61) after adjustment for age, gender, study center, body mass index, previous cardiovascular disease, Mini Mental State Examination score, and cardiovascular risk factors. Further adjustment for current use of medication for sleep and for depressive symptoms slightly diminished the HRs. EDS was equally predictive of mortality in those who snored loudly and in those who did not. EDS was related to cardiovascular mortality but not to mortality attributable to cancer.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic>Conclusion\u2014<\/jats:italic>\n                    <\/jats:bold>\n                    EDS might be independently associated with total and cardiovascular mortality in community-dwelling elderly.\n                  <\/jats:p>","DOI":"10.1161\/strokeaha.108.530824","type":"journal-article","created":{"date-parts":[[2009,2,26]],"date-time":"2009-02-26T21:58:37Z","timestamp":1235685517000},"page":"1219-1224","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":164,"title":["Excessive Daytime Sleepiness Is an Independent Risk Indicator for Cardiovascular Mortality in Community-Dwelling Elderly"],"prefix":"10.1161","volume":"40","author":[{"given":"Jean-Philippe","family":"Empana","sequence":"first","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Dauvilliers","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Franc\u0327ois","family":"Dartigues","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Ritchie","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Gariepy","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Jouven","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tzourio","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Amouyel","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Besset","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Ducimetiere","sequence":"additional","affiliation":[{"name":"From INSERM U909, Cardiovascular Epidemiology and Sudden Death (J.P.E., X.J., P.D.), Paris V University, IFR69-Paris Sud University, France; INSERM U888, La Colombiere Hospital (Y.D., K.R., A.B.), Montpellier, France; the Department of Neurology (Y.D.), Ho\u0302pital Gui de Chauliac, Montpellier, France; INSERM U593, Bordeaux 2 University (J.F.D.), Bordeaux, France; the Center of Preventive Cardiovascular Medicine (J.G.), Broussais Hospital, Paris, France; the Department of Cardiology (X.J.), G Pompidou..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","unstructured":"Institute of Medicine of the National Academy of Sciences. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington DC : National Academies Press 2006."},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043104"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200505-702OC"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200611-1588OC"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/19.4.277"},{"key":"e_1_3_2_6_2","first-page":"12","volume":"65","year":"2004","unstructured":"Young TB. Epidemiology of daytime sleepiness: definitions, symptomatology, and prevalence. J Clin Psychiatry. 2004; 65 Suppl 16: 12\u201316.","journal-title":"J Clin Psychiatry"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199008233230805"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/21.1.27"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2869.2007.00606.x"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjhyper.2004.05.009"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1996.tb01834.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb03901.x"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2001.49125.x"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000072920"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000257983.62530.75"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000147968.48379.c3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/atvb.20.6.1622"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.8.893"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(97)00296-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.4.904"},{"key":"e_1_3_2_21_2","first-page":"1979","volume":"84","year":"1999","unstructured":"Irwin M, Thompson J, Miller C, Gillin JC, Ziegler M. Effects of sleep and sleep deprivation on catecholamine and interleukin-2 levels in humans: clinical implications. J Clin Endocrinol Metab. 1999; 84: 1979\u20131985.","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031562"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/9.4.519"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.108.530824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T08:10:49Z","timestamp":1715587849000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.108.530824"}},"subtitle":["The Three City Study"],"short-title":[],"issued":{"date-parts":[[2009,4]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2009,4]]}},"alternative-id":["10.1161\/STROKEAHA.108.530824"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.108.530824","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4]]},"assertion":[{"value":"2008-07-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-10-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}